Lean Body Mass as a Predictor of Drug Dosage
Lean Body Mass as a Predictor of Drug Dosage
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去脂体重作为药物剂量的预测指标
DOI：
--
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发表时间：
1994
影响因子：
4.5
通讯作者：
Kelly M. Bray
中科院分区：
文献类型：
--
作者：
D. Morgan;Kelly M. Bray
有越来越多的证据表明，瘦体重（LBM）可能是一个更好的预测药物剂量比总体重（TBW）或体表面积（BSA），虽然这是不清楚的理由。LBM，这是类似的，但不完全相同的去脂质量，可以通过许多不同的方法来确定。基于TBW和身高的简单方程或生物电阻抗测定可能最适合用于药物处置研究。相对亲水性药物的分布容积与LBM非常相关，相关系数高达0.9。LBM可用于准确预测这些药物达到目标峰血药浓度所需的负荷剂量。对于亲脂性药物，分布容积与TBW的相关性优于与LBM的相关性。肾脏药物清除率与LBM之间关系的研究很少受到关注，这可能是因为肌酐清除率是一种有用且易于获得的肾功能标志物。然而，有限的数据表明，肌酐清除率和LBM一起可能比单独肌酐清除率更能解释肾清除率的变异性。对于主要通过肝脏消除的许多药物，全身清除率和LBM之间存在良好的相关性。这种相关性可能是由于全身清除率与肝脏大小或肝脏血流量之间的相关性，这已经在一些药物中得到证实，以及LBM与肝脏大小和血流量之间的相关性。LBM与器官大小和血流量之间的相关性尚不清楚，但LBM与药物清除率之间的良好相关性表明LBM可能是维持剂量的准确预测指标，尤其是在LBM与TBW之间存在较大差异的肥胖患者中。BSA是婴儿和儿童药物剂量的准确预测因子，但在该人群中LBM是否上级BSA仍有待确定。在大多数基于LBM的成人剂量前瞻性评价研究中，LBM作为药物剂量的预测指标已显示出优于其他体型指标的上级。
SummaryThere is mounting evidence to suggest that lean body mass (LBM) may be a better predictor of drug dosage than either total bodyweight (TBW) or body surface area (BSA), although the rationale for this is not clear.LBM, which is similar but not identical to fat-free mass, can be determined by many different methods. A simple equation based on TBW and height, or determination by bioelectrical impedance are probably the most suitable for use in drug disposition studies. Volume of distribution of relatively hydrophilic drugs correlates very well with LBM, with correlation coefficients of up to 0.9. LBM can be used to accurately predict the loading dose required for these drugs to attain a target peak plasma concentration. For lipophilic drugs, volume of distribution correlates better with TBW than with LBM.Investigation of the relationship between renal drug clearance and LBM has received little attention, probably because creatinine clearance is a useful and readily available marker of renal function. However, limited data suggest that creatinine clearance and LBM together may account for more variability in renal clearance than creatinine clearance alone. For many drugs eliminated predominantly by the liver, there is a good correlation between systemic clearance and LBM. Such a correlation could be due to a correlation between systemic clearance and liver size or liver blood flow, which has been demonstrated for a few drugs, and a correlation between LBM and liver size and blood flow. The presence of a relationship between LBM and organ size and blood flow has, however, not been investigated to date.A good correlation between drug clearance and LBM indicates that LBM may be an accurate predictor of maintenance dosage, especially in obese patients, in whom there is a large discrepancy between LBM and TBW. BSA is an accurate predictor of drug dosage in infants and children, but whether LBM is superior to BSA in this population remains to be determined. In most studies in adults in which dosage based on LBM has been evaluated prospectively, LBM has been shown to be superior to other measures of body size as a predictor of drug dosage.
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DOI：
10.1093/ajcn/37.5.735
发表时间：
1983-05
期刊：
The American journal of clinical nutrition
影响因子：
--
作者：
E. Presta;Jack Wang;G. Harrison;P. Björntorp;W. Harker;T. V. Itallie
通讯作者：
E. Presta;Jack Wang;G. Harrison;P. Björntorp;W. Harker;T. V. Itallie
囊性纤维化的胃肠道表现：综述。
影响因子：
29.4
作者：
Park,RW;Grand,RJ
通讯作者：
Grand,RJ
肥胖者的瘦体重。
影响因子：
4.9
作者：
Forbes,GB;Welle,SL
通讯作者：
Welle,SL
青春期唾液安替比林药代动力学的变化与年龄、激素水平和坦纳阶段相关。
DOI：
--
发表时间：
1991
期刊：
Developmental pharmacology and therapeutics
影响因子：
--
作者：
Linday,LA;Greenblatt,DJ;Warren,MP;Harmatz,JS;DeCresce,R;Cicalese,C;LeDuc,BW
通讯作者：
LeDuc,BW